BODYTEC Medical Clearance Certificate Dear General Practitioner, Your patient Da Oo Cavet {f0__ is required to receive medical clearance before participating in our personal training program at BODYTEC. Please review and complete the attached documents, which consist of the following: 4, Patient identifying information and information authorization 2. Explanation of EMS training with BODYTEC® 3. Brief review of sport science research findings 4, Contraindications 5. Medical Consent 1. Patient identifying information and information authorization Patient Name Orn ro Address Sz Puls pan Rd Vor aroyside UaAb Phone Number E-mail Address October 2015BODYTEC 2. Explanation of EMS training with BODYTEC® ‘The muscle stimulation via electric current is generally described as electro-muscle stimulation (EMS). Since the introduction of technology enhanced training methods, such as EMS, as anew and more time efficient option for general and whole body strength training, a lot of research has been done to validate the effects, of such training on the human body. At BODYEC®, we utilize this stimulus principle to enhance muscle strength training and strength endurance training, 2s well as to facilitate moderate muscle growth processes through muscular activity. Additionally, our training contributes to pain and symptom treatment, particularly at back and incontinence complaints through the increase of intra- and intermuscular coordination by activating the core muscles. We therefore use a combination of active bodyweight resistance exercises and faradic stimulation. This means, a corresponding electrical impulse is additionally applied from the outside on a deliberate contraction of the musculature (dynamic movement). So the muscle experiences a considerably additional voltage rise, an optimized increase of frequency and recruitment of its muscle fibres and therefore an even more effective settling of the stimulus. All training sessions at BODYTEC® are designed in short-intervals with a as contraction ~ 4s rest ratio and are always guided by a qualified personal trainer, using slow bodyweight movements only, which are gentle fon joints and are never accompanied by any other external equipment or weights. The training sessions are designed for a maximum of 20 minutes and we recommend our clients to do one training session per week. 3. Brief review of sport science research findings ine and rehat EMS training has been used for decades in the field of sports me ation. Over the last 10 years EMS training has widened its spectrum of application to include general fitness and sports performance. Therefore a wealth of research information exists on EMS training amongst its different areas of application and has proven its scientific effectiveness. The results of most research across different age, training and population groups has shown positive results and the general assumption of sport and medical scientists is that EMS training is an effective and suitable alternative to conventional strength training, ‘Some of the most significant research findings have shown positive trai ing effects on muscle-mass (Kemmier & Von Stengel, 2013) and research from the German Sports University Cologne (Filipovic et al, 2011; Speicher et al., 2008) found si relatively short period of EMS tral icant improvements in speed and maximum strength after a ing (for athletes as well as for non-athletes). (October 2015BODYTEC 5. Medical Consent Please be advised that my patient should be subject to the following restrictions in this fitness program: No kody weg hts Under no circumstances should my patient do the following: Wend loud, cuokomce {dnnihG Aad ay Gg Wer. | have discussed the foregoing restrictions and limitations with my patient and, with these specific restrictions, he or she has my consent to participate in the BODYTEC* personal traning programme under guidance of a qualified trainer. Sincerely, Date: Aco C-C Balttan {Please print name here) ‘October 2015BODYTEC Research in the field of rehabilitation at the University of Bayreuth (Boeck-Behrens et al., 2002) has shown significant levels of pain relief in participants suffering from back pain. EMS training has further shown to be an effective training method for the elderly (Kemmler & Von Stengel, 2012) and for cardiologic patients, as research from Bad Oeynhausen has shown (Fritzsche et al., 2010). EMS training with BODYTEC" has been scientifically proven to be effective for people of different age ‘groups and different fitness levels. However, certain medical conditions are known to be contraindications and EMS training with BODYTEC’ is not recommended. There are three absolute contraindications for the training: (1) pregnancy, (2) pacemaker or other electrical implants and (3) acute illness, such as fever, viral infections or acute inflammatory processes. For some medical conditions, BODYTEC® requires a doctoral suitability assessment for the training, which needs to be assessed on an individual case to case basis. Some of the most common medical conditions* requiring assessment include the following: + Circulatory disorders; acute stroke; stent; thrombosis and cardiovascular diseases (Le. arteriosclerosis) «+ Bleeding; bleeding tendency or haemophilia © Diabetes mellitus ‘+ Abdominal wall hernia or inguinal hernia ‘+ Severe neurological disorders (i.e. ¢ -psy, multiple sclerosis, amyotrophic lateral sclerosis etc.) + Acute operation (within 8 weeks, depending on individual case) Depending on the severity of the condition or predictable side-effects leading to a possible worsening of perceived symptoms, a GP is required to provide medical consent (please see below), before the training with BODYTEC® can be taken up or commenced. For any further questions, queries or required information about the EMS technology, technical details, research or training-related information, please contact BODYTEC* Head Office: Email: bodytec.co. Phone: 021-418 3479 otober 2018,